Article Text

PDF

Bacterial STIs
P47 Systematic recall vs standard care, addressing the increased risk of re-infection in patients presenting with gonorrhoea
  1. K Fernando1,
  2. S Flew1,
  3. J Phattey1,
  4. J Harding1,
  5. T Fowler2,
  6. M Caley3,
  7. J Ross1
  1. 1Whittall Street Clinic, Birmingham, UK
  2. 2Department of Public Health, Chief Medical Officers Private Office
  3. 3Department of Public Health, NHS Warwickshire/Warwickshire County Council, Warwick, UK

Abstract

Background Gonorrhoea is of increasing concern in UK, with the gonococcal resistance to antimicrobials surveillance programme reporting high levels of resistance to antibiotics. Prior history of gonorrhoea is a strong predictor of current infection, supporting the concept of a group of “core transmitters.” The US Center for Disease Control advises retesting of patients with gonorrhoea 3 months after treatment to identify repeat infections. Current UK guidelines only recommend a test of cure at 2–4 weeks.

Aim To assess the feasibility, acceptability and effectiveness of routine retesting at a 3-month interval, in UK sexual health clinic attendees diagnosed with gonorrhoea.

Methods Attendees between November 2010 and June 2011 diagnosed with gonorrhoea were offered retesting 3–6 months after treatment, with a subsequent reminder to attend (recall arm). Re-attendance rates and frequency of gonorrhoea diagnosis were compared to a historic group who attended between October 2006 and April 2007, controlling for age, sex, sexual orientation and history of STI (control arm).

Results 242 patients were assessed in the recall arm. 95 (39%) re-attended within 6 months of initial attendance and 15 (6%) were positive for gonorrhoea. Of 202 controls, 44 (22%) re-attended within 6 months and 12 (6%) tested positive for gonorrhoea. Being actively recalled increased re-attendance at the clinic (β=2.2, p=0.001) but did not detect additional cases of gonorrhoea (β=1.2, p=0.9).

Conclusion These results strongly suggest that the CDC recommendation for re-testing for infection after 3 months is not an effective approach for unselected patients with gonorrhoea in the UK.

Statistics from Altmetric.com

Request permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.